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- Blixt, S., et al.
(author)
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Validity of the short musculoskeletal function assessment questionnaire in patients with a spine fracture
- 2023
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In: European Spine Journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 32, s. 1471-1479
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Journal article (peer-reviewed)abstract
- PurposeThe aim of this study was to validate the use of the Short Musculoskeletal Function Assessment (SMFA) questionnaire in patients with a spine fracture.MethodsCross-sectional cohort of individuals that had sustained a spine fracture (C1-L5) one year earlier. Patients were asked to fill out SMFA, Oswestry Disability Index (ODI), EQ-5D-3L and EQ-VAS. Spearman's rank correlation coefficient (rho) was used to assess convergent validity for each patient-reported outcome measure (PROM). Bland-Altman plots were used to assess PROM agreement.Results82 patients completed all questionnaires. The correlations between SMFA Dysfunction and Bother indices and ODI were 0.89 and 0.86, with EQ-5D-3L index 0.89 and 0.80, and with EQ-VAS 0.80 and 0.73, respectively. The correlation for separate categories of the SMFA dysfunction index (daily activities, emotional status, arm and hand function, mobility) ranged between 0.71-0.87 for ODI, 0.72-0.84 for EQ-5D-3L index, and 0.67-0.77 for EQ-VAS. A selection of the ten items of SMFA that had the highest correlations with ODI resulted in a correlation of 0.91. The agreements between SMFA indices and ODI in Bland-Altman plots were good with small differential biases and minimal proportional biases, but worse for SMFA and EQ-5D-3L index and EQ-VAS.ConclusionThe SMFA indices are highly correlated with ODI in patients with a spine fracture. The Dysfunction index and Bother index, or selected SMFA items, may be used to assess outcome in patients with spine fractures as an alternative to ODI.
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| 2. |
- Pazarlis, Konstantinos, MD, 1983-
(author)
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On the Diagnosis and Treatment of Lumbar Spinal Stenosis
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Lumbar spinal stenosis (LSS) is the most common indication for spinal surgery. The aging global population is increasing the demand for strategies that promote physical activity among the elderly. As the prevalence of LSS rises, the condition gains constantly demographic and socioeconomic attention. Until recently, there has been no clear consensus regarding LSS treatment. Further, using electrodiagnostic examinations (EDX) as predictive tools to identify surgical candidates, could lead to a more tailored medical approach. Methodological issues in previous studies have left some questions unanswered. The necessity of extensive surgery for LSS remains a topic of debate among spinal surgeons, which this work addressed by analyzing data from 723 patients. Parts of the work aimed to compare surgery and structured non-surgical treatment for LSS (Paper I, II, III). Furthermore, it aimed to investigate, by means of EDX, whether the degree of neurological affection correlates to the surgical outcome of LSS (Paper I, II). Additionally, this work evaluated the radiological outcome for surgical vs non-surgical treatment for LSS in terms of sagittal balance parameters (Paper III, V). Finally, parts of this thesis aimed to confirm findings from previous studies regarding DA and DF for LSS with DS (Paper IV, V). The current thesis is based on two randomized controlled trials and a cohort study: the Uppsala Spinal Stenosis Trial, the Swedish Spinal Stenosis Study, and the Cohort Study on LSS with DS. Patient reported outcome measures from the Swedish National Quality Registry for Spine Surgery (Swespine) were used to collect follow-up data. We concluded that at six months, surgery with decompression leads to superior clinical outcome, compared to structured physical therapy. The improvement is not affected by delay of surgery (Paper II). EDX does not add predictive value when assessing the patients for eligibility before surgery (Paper II). DA improves the spinal sagittal balance, regardless of preoperative DS (Paper III) and provides good two-year clinical outcome in LSS with DS with low rate of complications, and low need for subsequent surgery (Paper IV). New radiological stenosis was less common two years after DA than after DF, in LSS with or without preoperative DS (Paper V).
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